your opinion

[LarryUSA]

Hello all, I am writing my MBA thesis on socialized healthcare in the U.S. Anyone care to give their opinion?

[insenescence1]

I think it's a great thing to write about.

What is the proposition of your thesis, and from what origin/point of view are you writing?

[Edson!]

It's the best thing since MRSA.

I certainly expect to see more of it--SM as well as MRSA, that is.

In fact, I expect SM will help propagate MRSA and other such ugly illnesses--or at the least, it will increase the M&M from such illnesses.

But what the heck. . .the world is projected to hit >7Billion in population by 2009. Anything "socialized" is bound to put the breaks on that.

Shoot I can see aristocratic as well as some proletariat socialists believing in such things. Afterall, no one sees "the big picture" like a socialist. . . or at least one "taught" to think like one.

[LarryUSA]

I think it's a great thing to write about.

What is the proposition of your thesis, and from what origin/point of view are you writing?

My porposition is that it can work here. Only problem is, no one seems to want to pay for it with higher taxes. I've researched other contries and it seems most systems suffer from fraud, waste, and abuse.
I'm sure we will have our share of the same, but I'm trying to prove that it will be worth it in the bigger scheme of things.

[PWhite]

Have you researched the workings of the health care system in France?

[insenescence1]

My porposition is that it can work here. Only problem is, no one seems to want to pay for it with higher taxes. I've researched other contries and it seems most systems suffer from fraud, waste, and abuse.
I'm sure we will have our share of the same, but I'm trying to prove that it will be worth it in the bigger scheme of things.

We can have any kind of system we want.

A socialized system will work, it will just not be as good for US health-care consumers.

Fraud will increase as providers see their reimbursements SLASHED. Yes, surprising to some I suspect, in spite of how people criticize insurance companies, these private insurers reimburse better than gov't programs (i.e. medicare, medicaid). I don't know how we could suddenly expect the gov't to be more generous just because they are the ONLY NON-COMPETITIVE payor.

Abuse will increase because people will suddenly think it's "free." We see how that works out for places like Canada. Double-digit percentages of citizen's who can't even get assigned a primary care physician. Waiting lists...everywhere. Surgery, outpatient, emergency rooms.

Providers will leave in droves. Since reimbursement will decrease, wages will decrease. Frence physicians make on average about 40% of what US physicians make. Given that I doubt we are going to start making medical school free, I don't think too many US physicians will agree to a 60% wage cut. I know I am not willing to take a wage cut as an RN...and we already are in what appears to be an almost terminal shortage of RN's.

I only mention France because it was already brought up. Nearly 90% of French citizens purchase supplemental health insurance, and they don't consider their system socialized...they are in fact critical of "socialized" systems like the UK.

A key issue; liability. In the US, we are tort-crazy and have massive payouts for malpractice. France limits liability, thereby reducing both payouts (a small part of our health expenditures, but would become a comparatively larger portion in a system with a smaller budget), and also reducing the expensive practice of defensive medicine. Advocates of socializing the US system are generally opponents of tort reform, apparently unknowingly wanting to try to blend two incompatible conditions. These advocates are also generally pro-union, trying to increase the wages and benefits of workers...also a condition that will be incompatible with a system that cannot support union demands. I don't see a union agreeing to cuts in wages and benefits, and higher patient wages, justifying it with, "well, at least everyone is now insured."

Rationing will become a replacement for "denied." People over a certain age will become ineligible (by policy) for a kidney transplant...it won't matter that they might be otherwise healthier than someone 20 years younger...who is eligible. Wait lists for surgery, we will still have to purchase separate insurance for eye and dental care ... my current employer (a health care system) plan covers my vision/dental, but they will have to cut costs somewhere to deal with reduced reimbursements in the face of continued competitive wages and lack of tort relief. They may drop insurance coverage altogether...we are will supposedly be covered by the gov't, right?

And unlike Canada, where will we go for relief? The majority of Canadian citizens live within driving distance of the US border, and currently can access our system when their system puts them on a waiting list. In the last year alone, over 100 high risk Canadian expetants (just from BC and Ontario) were sent to the US because of a lack of NICU beds. Last year, a Canadian mom (Jepp) about to deliver a rare set of quadruplets had to be sent to Great Falls, Montana because there weren't any beds in ALL of Canada. This just boggles my mind. Great Falls? Canada is sending their highest risk neonates to Great Falls Montana but Canadian neonatal care and outcome is supposedly better than ours? Does anyone see why I am such a cynic when it comes to the WHO and rankings and the superiority of socialized care?

If the US system socializes, it will reduce accessibility for Canadians as well as Americans...but we won't have the convenience of driving across the border to get ahead in line. I'm sure a few could go to Mexico, but it will solve very little.

Finally, we can expect research dollars to shrink. MD Anderson Hospital in Texas spends more on cancer research than the entire country of Canada. That is just one US hospital. California has promised BILLIONS for stem cell research, more than the few million than Canada submits. Once we start rationing dollars for a socialized system, these dollars will be just as available as they are in socialized countries...remarkably less. Again, advocates of socialized systems also tend to be advocates of federal funding for controversial research like stem cells...failing to realize that they are once again trying to blend incompatible conditions.

Folks who desire socializing the US system are failing to think this through...and are using inaccurate numbers as well. The 44-47 million uninsured is simply an inaccurate number.

[insenescence1]

May I add two things...

France is often held up as an example of a successful socialized system, but I think the true description of their system may be debatable. I want to point out that they were listed in 2000 by the WHO as the number one health system in the world. After a few years of taking a beating on methodology, the WHO revised their list, placing France at #5...still one of the top in the world. That year, almost 15,000 French citizen's died when a heat wave hit a whopping 104 degrees a couple times. For reference, Phoenix see's over 100 for approximately 90 days per year, and only approx. 1800 died in Katrina two years later.

Chirac blamed it on the health system for failing to accomodate the increased load, and also blamed it on the citizens for failing to care for their families.

Second, most French workers also receive supplemental health insurance from their employers (hence why there is such a high percentage of privately insured French citizens...~90%). One of the reasons that French companies can afford this is because France's corporate tax rates are lower than the US (like most of Europe...which is why they can afford to buy US companies like Anheiser). This allows French companies to retain skilled and talented labor by affording employee health benefits instead of giving their money to the gov't.

I also wanted to add; France doesn't seem to get in the way of common sense when it comes to accomodating it's energy needs. Some would think it irrelevant, but overall costs make a difference.

Nearly 80% of their domestic energy production is nuclear...and it makes money on this by exporting a lot of it (the largest world exporter of electricity) while keeping it's per capita electrical costs the lowest in Europe.

[chosenrev12]

Have you researched the workings of the health care system in France?

In every country,there are many issues uprising concerning health sytems.In every state.I would like to see people sharing there opinions more often.Weather good or not,being honest and not hiding the truths of matters.Ide like to see them put in action the routes and upholding those things needing changes in world today.Not covering issues up,or making excuses for them.Truth always prevails.Im not saying that everything in health sytems in government is wrong or bad,im saying that many things are getting much better,and people i find are living longer.I also believe that there are many issues today that are not looked at,or taken sereously,and causing harm in major ways for peoples lives today around the world.I dont care if your a mission,a hospital,ccs,or the military,it doesnt matter what kind of organization you are,these issues are important no matter what,in order to uprise healthy indeviduals in the world today.